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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610464
Report Date: 05/21/2024
Date Signed: 05/21/2024 12:13:58 PM

Document Has Been Signed on 05/21/2024 12:13 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:UNIQUE GROUP HOMEFACILITY NUMBER:
197610464
ADMINISTRATOR/
DIRECTOR:		OMOTAYO, BABATUNDEFACILITY TYPE:
735
ADDRESS:8045 GROVE STTELEPHONE:
(818) 770-2940
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY: 4CENSUS: 0DATE:
05/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:55 AM
MET WITH:Kenneth Uzoma (Staff)TIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analysts (LPAs) Michael Cava and Evelin Rios conducted a Case Management visit to hand deliver an "Order to Individual for Immediate Exclusion from all Facilities" to Staff #1 (S1). LPAs met with staff Kenneth Uzoma who contacted the Administrator/Licensee Babatunde Omotayo by telephone. LPAs explained to Administrator/Licensee the purpose of the visit. Administrator/Licensee, designated staff Kenneth to sign todays report.

It was determined by the Department that a complaint of conduct inimical, of C1 was substantiated against S1. S1 will also receive copies of the “Order To Licensee/Facility Of Immediate Exclusion From Facility” for the facilities with which S1 is associated with.

Administrator/Licensee stated, S1 has not worked at this facility. According to Administrator/Licensee S1 was associated to the previous license at this address and prior to that S1 was living here with his family as a private residence. Administrator/Licensee states, S1 and his immediate family still receive mail here.

Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE: DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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